Depo-Provera
The World Health Organization (WHO) has cleared the use of injectable contraceptive, Depo-Provera, which was earlier said to enhance chances of HIV infection.
WHO said a study that last year linked the injectable contraceptive to the possible spread of the virus among discordant couples was inconclusive and could thus not be relied on to ban the contraceptives that are commonly used by millions of women around Tanzania and the rest of the world.
In an email on Tuesday, the WHO spokesperson Fadela Chaib said a two-day technical consultation from January 31 to review findings from all recent population-based health studies on the issue concluded that there were no restrictions on the use of any hormonal contraceptive method for women living with HIV/Aids or at high risk of HIV.
However, WHO still advised that women who rely on injectable contraception should also use condoms to protect them against HIV infection. The confirmation by WHO is likely to give relief to Tanzanian women who have been using the contraceptive. The government has in the period of one year tripled the budget for contraceptives after reported shortages in past years, all in effort to control annual population growth rate at 3 per cent.
Depo-Provera is the cheapest and most popular contraceptive in the country since it controls pregnancy for three months after it is administered. The news will come as a big relief to millions of users, who had been worried over the finding. It will also be a welcome intervention for African governments, including Tanzania, whose family planning efforts may have suffered a hitch if the cheaply available contraceptives would have remained unrestricted.
Publishing online, researchers at the Lancet Infectious Diseases led by Renee Heffron – basing on a study of nearly 3,800 HIV-1 sero-discordant couples from seven African countries – on October 4, last year said women using hormonal contraception, primarily Depo Provera, had twice increased risk of acquiring HIV. The findings caused consternation, especially among family planning experts. But the guidance says, “it is critically important that women at risk of HIV infection use condoms and where appropriate, other measures to prevent and reduce their risk of HIV infection and sexually transmitted infections.”
In Tanzania, less than 10 per cent of those on family planning use the injection method. The majority, however, prefer pills (oral) and a small percentage uses condoms and other natural means like withdrawal or abstinence. Chaib said WHO convened a technical consultation from 31 January – 1 February, this year to review findings from all recent epidemiological studies on the issue.
The meeting brought together 75 experts from 18 countries to review existing WHO recommendations in the light of these findings. The experts recommended that women living with HIV or at high risk of HIV, continue to use hormonal contraceptives to prevent pregnancy, but emphasized the need to also use condoms to prevent HIV acquisition and transmission. They also stressed the need for further research on the issue and the importance of offering a wider choice of contraceptive options.
On 15 February , WHO’s Guidelines Review Committee upheld the recommendations. The Guidelines Review Committee is the body responsible for ensuring that all WHO recommendations are based on the best available scientific evidence and have been developed in a transparent, unbiased and clearly reported manner.
By ORTON KIISHWEKO, Tanzania Daily News
